As government agencies at the local, state, and federal level strive to achieve the promise of community inclusion, they must address the issue of transportation. Community inclusion is not only about where someone lives, but also about his or her relationship with the surrounding community: without a way to get around, a person can remain isolated. Meaningful community inclusion requires that a person have access to transportation that is both affordable and available for desired purposes.
Although transportation remains a missing puzzle piece in many communities, some communities have developed innovative solutions to providing transportation to people with psychiatric and other disabilities. At the very heart of community inclusion is the ability to interact with other members of the community and to take part in the same types of activities as everyone else.
After the passage of the Americans with Disabilities Act, the U.S. Department of Justice determined that the states must provide services in “a setting that enables individuals with disabilities to interact with non-disabled persons to the fullest extent possible.” The Supreme Court later noted in Olmstead v. L.C. that institutionalization “severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment.”
Unfortunately, for many people with psychiatric disabilities, transportation remains one of the most significant obstacles to community inclusion. In many rural communities, transportation options are non-existent or severely limited. In those communities, people with psychiatric disabilities sometimes receive transportation to and from medical and rehabilitation services, but often do not have access to transportation for shopping, work, school, social events, or other activities of daily life. Although many urban and suburban communities offer transportation in the form of public transit and specialized transportation for people with disabilities, these resources are not always available to people with psychiatric disabilities.
One major reason is affordability: People relying on Supplemental Security Income (SSI) or other forms of income supports, faced with many other expenses, often cannot afford to spend limited resources on relatively inexpensive public transit. Van services for people with disabilities often cost more than public transit, and frequently people with psychiatric disabilities do not meet the eligibility criteria, which are geared toward people with physical disabilities and visual impairments. In rural communities, innovative programs have typically addressed transportation as a community problem facing low-income people, people with disabilities, older adults, and others in the community – and thus have attempted to develop a comprehensive solution. Some examples of solutions developed by rural communities include: recruiting volunteers to provide free or low-cost rides; using mental health block grant funds to support; generating peer-run transportation programs; and soliciting donations of used vehicles for distribution to low-income people.
The Community Transportation Association of America offers several useful publications about such solutions through its National Transit Resource Center. Service providers in several rural communities have experimented with issuing travel vouchers. These vouchers, which the sponsoring agency redeems for cash, can be used to obtain transportation from anyone willing to provide the holder with transportation, including taxi companies, other social service agencies with vans, and even friends and family. Additional information about voucher programs is available from the Association of Programs for Rural Independent Living and the Research and Training Center on Disability in Rural Communities.
In urban and suburban areas, programs seeking to provide transportation to people with psychiatric disabilities have generally focused on improving access to existing transportation resources, most often public transit. One approach has been to advocate for people with psychiatric disabilities to receive discounts available to many people with disabilities. Although federal law requires states to provide reduced transit fares to people with physical disabilities and to people with Medicare cards, this benefit excludes many people with psychiatric disabilities who cannot afford transit fares. Some transit systems have extended the discount to people receiving other forms of disability benefits, and advocates in New York successfully pushed for a state law guaranteeing reduced fares to many people with psychiatric disabilities.
Other means of making public transit more affordable to people with psychiatric disabilities is issuing weekly or monthly transit passes to Medicaid recipients. States must fund transportation to covered services, and Medicaid agencies in some areas have found it more cost-effective to issue monthly transit passes to recipients than to pay for van services to medical appointments. While saving money, these agencies also enable recipients to travel freely for other purposes such as shopping and social activities. The Federal Transit Administration has issued a publication explaining how Medicaid transit pass programs operate.
In addition to affordability, another obstacle for some people is learning how to use public transit and overcoming fear or confusion in riding buses and trains. In numerous communities, transit agencies or social service providers have developed transit training programs, often led by peers, which help people learn how to read maps and schedules, make connections, and otherwise navigate the transit system. Easter Seals Project ACTION offers publications helpful for designing such programs. Although transportation remains a major barrier to community integration, urban, suburban, and rural communities do have options for improving the mobility of people with psychiatric disabilities.
For more information about these options, contact the organizations and agencies listed below:
Association of Programs for Rural Independent Living 5903 Powdermill Rd. Kent, OH 44240 (330) 678-7648 http://www.april-rural.org
Community Transportation Association of America 1341 G. Street, NW, 10th Floor Washington, DC 20005 (800) 527-8279 http://www.ctaa.org
Easter Seals Project ACTION 700 Thirteenth St., NW, Suite 200 Washington, DC 20005 (202) 347-3066 http://www.projectaction.org
Federal Transit Administration 400 7th St., SW Washington, DC 20590 http://www.fta.dot.gov
Research and Training Center on Disability in Rural Communities 52 Corbin Hall Missoula, MT 59812-7056 (888) 268-2743 http://rtc.ruralinstitute.umt.edu/